Strength and limitations of the study
A major strength of this retrospective population-based study was that
we were able to analyse a rare condition over a period of ten years and
therefore we were able to provide a true representation of placenta
praevia outcomes.
The present study has been conducted within a major referral and
tertiary hospital and thus we were able to recruit over 350 patients.
Additionally, our hospital is well resourced both medically and
surgically, with maternal-fetal-medicine obstetricians, gynae-oncology
specialists and interventional radiologists on standby to optimise
maternal care. Our results are widely generalisable because the study
hospital is representative of the type of tertiary centres where the
majority of these rare high-risk placenta praevia cases are referred.
The perinatal database utilised in this study is obtained from
obstetrician documentation and routinely undergoes large
institution-based rigorous examination for accuracy to mitigate risk of
misclassification and recall bias, which are intrinsic limitations
associated with retrospective studies.
The authors acknowledge that though clinical practices may change over
the years with new clinical insights, it is unlikely to substantially
influence the results as effects would be equally distributed between
the comparison cohorts.